Open AccessPrevalence of antiphospholipid antibodies in Behçet's disease: A systematic review and meta-analysis
Author(s) -
Asiful Islam,
Sayeda Sadia Alam,
Shoumik Kundu,
A. H. M. Safayet Ullah Prodhan,
Shahad Saif Khandker,
T. M. Reshetnyak,
Przemysław Kotyla,
Rosline Hassan,
Tareq Hossan
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0227836
Subject(s) - medicine , lupus anticoagulant , meta analysis , antiphospholipid syndrome , venous thrombosis , odds ratio , publication bias , behcet's disease , thrombosis , gastroenterology , immunology , disease
Behçet’s disease (BD) is a multifactorial systemic inflammatory disease of unknown aetiology characterised by several clinical manifestations including vascular involvements ( i . e ., both arterial and venous thrombosis). Antiphospholipid antibodies (aPLs)—including anticardiolipin (aCL), anti-β2-glycoprotein I (β2-GPI) antibodies and lupus anticoagulant (LA) are detected in systemic autoimmune diseases which contribute to thrombosis. The aim of this systematic review and meta-analysis was to evaluate the prevalence of aPLs in patients with BD as compared to controls. A protocol was registered in PROSPERO (Registration No. CRD42018088125) and a systematic literature search was conducted through PubMed, Web of Science, Embase, Scopus and ScienceDirect databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects model. Quality assessment was carried out by using the modified 9-star Newcastle-Ottawa Scale (NOS). Publication bias was evaluated via visualisation of contour- enhanced and trim and fill funnel plots along with Begg's and Egger's tests. We included ten case-control studies (a total of 999 participants from 380 BD patients and 619 controls) based on the inclusion criteria. The prevalence of aCL (OR: 12.10, 95% CI: 5.15–28.41, p <0.00001) and anti-β2-GPI antibodies (OR: 23.57, 95% CI: 1.31–423.63, p = 0.03) were statistically significant, however, the prevalence of LA was not significant (OR: 13.77, 95% CI: 0.65–293.59, p = 0.09). The results remained statistically significant from different sensitivity analyses which represented the robustness of this meta-analysis. According to the NOS, 50.0% of the studies were considered as of high methodological quality (low risk of bias). No significant publication bias was detected from contour-enhanced and trim and fill funnel plots or Begg's and Egger’s tests. This meta-analysis established that there is a significantly high prevalence of aPLs ( i . e ., aCL and anti-β2-GPI antibodies) in patients with BD when compared to controls.